来氟米特联合小剂量激素治疗难治性原发性肾病综合征的疗效研究

Effect of leflunomide combined with low dose hormone on the treatment of refractory primary nephrotic syndrome

目的观察来氟米特联合小剂量激素治疗难治性肾病综合征的临床疗效及安全性。方法 94例难治性肾病综合征患者分别随机纳入研究组(45例)和对照组(49例),研究组给予来氟米特联合小剂量泼尼松治疗,对照组给予环磷酰胺联合小剂量泼尼松治疗,疗程均为24周。比较两组治疗前及治疗8、12、24周后的血生化、尿常规及24 h尿蛋白定量等各项指标、观察对比两组疗效及不良反应。结果治疗第8、12、24周后,同一时间研究组24 h尿蛋白定量和血肌酐水平低于对照组,而血清白蛋白水平高于对照组,研究组疗效显著高于对照组,不良反应发生率显著低于对照组。结论来氟米特联合小剂量激素治疗难治性肾病综合征疗效优于环磷酰胺联合激素的冲击疗法,且不良反应较小,值得推广应用。

Objective To observe the clinical efficacy and safety of leflunomide combined with low dose of hormone for treating refractory nephrotic syndrome. Methods 94 cases of refractory nephrotic syndrome patients were randomly divided into study group( n = 45) and control group( n = 49),patients in study group received the treatment of leflunomide combined with low dose of prednisone,meanwhile the patients in control group received cyclophosphamide combinedwith prednisone,and the therapy lasted for 24 weeks. Compare the blood biochemical indexes,routine urine,24h urinary protein of thetwo groups at the time points preoperative and 8,12,24 weeks. Observe the curative effect and the occurrence of adverse reaction. Results 24h quantitative urinary protein and creatinine levels in serum of study group were significantly lower than those of control group at the time points of 8,12,24 weeks after the treatment,but the serum albumin level was higher than that of control group. The curative effect of study group was significantly higher than that of control group,but the incidence of adverse reaction was lower than that of control group. Conclusions Leflunomide combined with low dose of hormone performed more effective in the treatment of refractory nephrotic syndrome than cyclophosphamide combined with hormone,and less adverse reactions,it is worthy of popularization and application.